So yesterday was my birthday.
I'm just glad I wasn't turning 40--that might have been one stress too many!
The day included:
1-outpatient chemo treatment
1-long visit with the radiation oncologist
1-trip to the DMV to renew my driver's license
I think the DMV was the worst :)
Seriously, it was a tough day. The chemo went great--quick, relatively painless, and his porta-cath was de-accessed for the first time since it was put in. So we came home without tubes sticking out his chest, a remarkably good feeling.
But the radiation oncologist was a different matter. She was out of town when we were in the hospital last week, so we'd only met her resident. (Who, by the way, looks like he's 12. Seriously. We met some young doctors last week, but this guy looks younger than my teenager.) So yesterday was our day to meet Dr. Lynn Smith. We knew Jacob would be having radiation in conjunction with chemo, but we hadn't realized how involved the process would be, nor how difficult the side effects.
Next Tuesday, we'll go to the Huntsman Cancer Institute for treatment planning, which will involve a PET scan and a CT scan to precisely map his tumor. They want it down to millimeters so they don't target anything they don't have to with radiation. He gets a cool plastic mesh mask on which they'll draw the markings so his face doesn't have to be tattooed. Apparently there's a tech who will decorate the mask however he wants. He's leaning toward a Boston Red Sox theme. When the scans are finished, it will take them nearly two weeks to precisely plan their treatment. Then we begin.
At the moment, Jake's scheduled for his first radiation treatment on Monday, January 28. They aren't terribly long--about an hour of total time from arriving to leaving--but they are every single weekday for 28 treatments, which is 5 1/2 weeks. (At this point, I was thinking, "Man, I'm glad I don't live in Wyoming or Idaho or southern Utah!")
And the side effects are cumulative--they will get worse as we go along. Sensitive skin at the radiation site I can handle. Fatigue, no problem. Even mouth sores--well, we've had a little touch of that already with chemo.
I was not prepared to have her say that virtually every patient treated in the head/neck area end up having IV nutrition for a time because their mouths and throats become so sore that they won't eat. That was discouraging to hear. She did say that with pediatric patients they try to avoid the nasal-gastric tube and instead to have parents supplement through the porta-cath. I guess if I can give shots I can push stuff into a tube. (Yes, I'm giving shots--I promise to get back to that soon.)
All in all, a reminded that he is ill. In spite of how good this week has been, how normally he's behaved, the truth is that we need to treasure our good days because there will be plenty of bad ones coming.
So I did the most motherly thing of all this morning--I made him go to school. Not for the whole day, but I told him that if February is going to be spent miserable from radiation, that he'd better go to school while he can.
I can't decide if that makes me a good, sensible, balanced mom or a cruel and sadistic mom. But all I can do at this point is make one decision at a time. That was today's decision. Now to start thinking about tomorrow's.